Bill To:


GEICO INSURANCE COMPANY
PO BOX 9515
FREDERICKSBURG, VA 22403-9515

Services Rendered To:


Savannah Nelson
415 N. US Highway 69, Apt. A8
Huntington, Texas 75949
POLICY # 4603243017


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  2. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    6
    $12.00
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00
  6. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  7. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: FM 2109 @ Pickard Road - Zavalla, Texas

Subtotal $1,087.00
Total Due $1,087.00


Updated
June 6, 2022 @ 2:23 pm

Invoice updated by Geoffrey.

Status Update
June 6, 2022 @ 2:23 pm

Status changed: Draft to Pending.